Baby Loss Awareness Week

Hannah Bardell Excerpts

Thursday 23rd September 2021 Commons Chamber

[Nickie Aiken]

I thank the hon. Member for her intervention, and I think it is clear from the debate today that there needs to be more support for women and their partners when they experience miscarriage. I will never forget, when I became pregnant with my daughter, how terrified I was of going for the 12-week scan, because my first experience had been one of baby loss and I had been told at that scan that the baby was not viable. I think I would have benefited from some counselling and some support when I was going for that scan for the second baby.

[Hannah Bardell (Livingston) (SNP)]

I thank the hon. Lady for the very powerful speech is making. I appreciate the very personal nature of what she is sharing, and it brings so much to this House that everyone is doing that. Would she join me in commending local organisations, such as Held In Our Hearts in my Livingston constituency, which has been operating for 40 years, that provide support with counselling services for those who have experienced baby loss, and does she agree that they are absolutely vital in supporting those who have suffered such loss?

[Nickie Aiken]

I thank the hon. Member for her intervention, and she is absolutely right. We are blessed in this country with having so many outstanding charities and organisations that support women and their partners when they are experiencing baby loss.

The Imperial College Healthcare NHS Trust study has revealed some incredible findings. For example, after one month following a pregnancy loss, nearly a third of women suffer post-traumatic stress, while nearly one in four experiences moderate to severe anxiety and one in ten has moderate to severe depression. These women are going through such pain, and it is clear that they need more support. The scale is truly astonishing. Here I think due consideration should be paid not just to the women, but to the bereaved families. As we heard from my right hon. Friend the Member for South West Surrey (Jeremy Hunt), this does affect the fathers involved. I remember, from my own experience, my husband going through such loss.

When I was researching for this debate, I reached out to an outstanding woman called Jane Scott, who is the senior bereavement midwife at the Imperial College Healthcare NHS Trust. She is here today I believe—I think in the Gallery above me—with her colleague Lauren Petrie. Midwives up and down this country do amazing work, but Jane in particular gave me powerful testimony before this debate. She explained that, before 2013, there was little or no provision in the labour ward she worked on at St Mary’s for parents who had experienced the death of a baby. Due to her tenacity, and to her basically battling the NHS trust, she was able to secure specialist services for bereaved parents. She told me that at the time she was battling,

“parental complaints were rife…Babies were going missing, funerals were going ahead without the parent’s knowledge, communication was poor which added longevity to the grieving process for parents…There was no provision for psychological support/counselling for parents.”

I was completely shocked when I read that, because to lose a baby, no matter how early in the pregnancy, and not to be able to have a funeral, is absolutely unacceptable.

With Jane’s hard work, and her setting up of bereavement services at St Mary’s, complaints from parents dropped by 90%. She said that the ward became almost unrecognisable, and much more of a positive place to be. Jane is a member of the all-party group on baby loss, and she continues to campaign to highlight the importance of understanding the effects of baby loss. She has now set up the national Bereavement Midwife Forum, which compares services, exchanges best practice, and provides support for midwives. There are now 250 members of the Bereavement Midwife Forum across the UK, and I pay tribute to Jane Scott and her fellow midwives for the outstanding work they provide.

From speaking to Jane, and others, I know that the Bereavement Midwife Forum firmly believes in, and is calling for, consideration for there to be one full-time bereavement midwife for every 3,000 deliveries in each trust. That is a reasonable request, and I would welcome any support that the Minister can provide to ensure that NHS trusts consider it. The forum is also calling for a standardisation of trauma counselling for bereavement midwives and bereaved parents. We must also ensure that there are band 8 regional bereavement midwives to oversee such services in each trust. Those are all sensible measures.

I wish to ensure that there is more support for midwives, particularly those who experience the dreadful death of a baby when looking after a mother—I cannot imagine how it must feel to be in that profession and experience that, and to work with a mother and a father who are going through such trauma. We must do more to support midwives, and doctors, who have that dreadful experience. Again, I thank my hon. Friend the Member for Truro and Falmouth for securing this debate. I am in awe of her. I also again pay tribute to all those midwives and doctors who work tirelessly day in, day out. To anyone who has experienced the bereavement of a lost baby I say this: you are not alone.

Future of the National Health Service

Hannah Bardell Excerpts

Wednesday 22nd September 2021 Westminster Hall

[Hannah Bardell (in the Chair)]

Before we begin, I encourage Members to wear masks when they are not speaking, which is in line with current Government guidance and that of the House of Commons Commission. Please also give each other and members of staff space when seated and when entering and leaving the room.

[Richard Burgon (Leeds East) (Lab)]

I beg to move,

That this House has considered the future of the National Health Service.

Against the backdrop of the deepest health crisis in decades, the Tories have launched a dangerous NHS Bill. The Bill is not an attempt to address the deep failings of the past decade, driven by austerity, cuts, privatisation and the disastrous 2012 reforms that marketised our NHS. It is about entrenching an even greater role for private companies in our NHS.

The new Health and Care Bill should really be called the NHS Americanisation Bill, because it is the latest stage in the corporate takeover of our NHS, one where private companies not only profit from people’s ill health but increasingly get to decide who gets what treatments and when. Those who believe, as we do, in the real principles of our NHS—free treatment, based on need, guaranteed as a right in a comprehensive system—should be deeply alarmed. Others will address their concerns about the Government’s latest plans. Here are just a few of my concerns.

The Bill will not end or reverse privatisation but will open the door to greater private involvement. It is a charter for corruption, with the dodgy allocation of contracts we have seen throughout covid becoming the norm. It will mean even more politically compliant cronies, as it gives the Secretary of State powers to decide the heads of the new local health boards—expect more Dido Hardings, and accountability to local communities to be reduced.

It will introduce strict caps on budgets, which could lead to serious rationing, with services cut to match funding, rather than funding matching health needs. We will have a postcode lottery for treatments. A new payment system would give providers, including private providers, a say in how much they should be paid for contracts won. It has the potential for staff to be paid according to local rates and conditions, creating a race to the bottom with the deregulation of the medical professions, potentially undermining the quality and the safety of care.

These reforms are part of a wider plan. That plan depends first on deliberately underfunding the NHS. Under the previous Labour Government, NHS funding increased by 7% a year; under the Tories, it increased by just 1.2% a year between 2009-10 and 2018-19, and by even less when the growing and ageing population is factored in. Although some new funding is planned through regressive taxes on working people, funding under this Government will still be well below the historic average that is needed. As Matthew Taylor of the NHS Confederation said:

“Extra funding is welcome. But the Government promised to give the NHS whatever it needed to deal with the pandemic, and while it makes a start on tackling backlogs, this announcement unfortunately hasn’t gone nearly far enough. Health and care leaders are now faced with an impossible set of choices about where and how to prioritise care for patients.”

That deliberate underfunding always goes hand in hand with greater privatisation. Waiting lists grow and people start to seek health provision elsewhere. As budgets are cut, that is used as the cover to bring the private sector into the NHS under the false arguments of efficiencies and savings, when the reality is that every pound spent bolstering the private companies is a pound less spent on people’s healthcare. Instead of more privatisation, the public overwhelmingly back the NHS being returned fully to being a public service.

The Bill is being spun as a way to address the huge failings of the Health and Social Care Act 2012, which placed markets at the heart of the NHS, but, in reality, it is simply a way to entrench privatisation in a different way. The Bill does not address the deepest failings of the 2012 reforms. For instance, while dropping the absurd competitive tendering process, the new Bill does not make it a requirement that the NHS is the default option for providing healthcare services.

The legal structure for the market remains. The profit-hungry vultures will still be circling and trying to pick a profit from human suffering. Foundation trusts will still be able to make from 49% of their income by treating private patients, and key outsourced services, including those provided by porters and cleaners, will not be brought back in-house.

As well as allowing private companies still to pocket public money, the Government’s plans also give private companies a chance to shape health policy directly. The Bill opens the door for private corporations to sit on the 42 local health boards—the so-called integrated care boards—that will make critical decisions about NHS spending. In a sign of what might be to come across the country, Virgin Care already has such a seat in Somerset. The Government are under political pressure on the issue, as we know, so we have seen some limited concessions, but they are not enough. The real solution must be that private companies have no role at all on these boards or in the running of our national health service.

The Bill also allows NHS local boards to award contracts to private healthcare providers with even less transparency than they do now. Contracts will be exempted from the public contracts regulations, which opens the door to yet more dodgy handouts to the Tories’ corporate mates, something that has become all too common during the pandemic—and the public know it.

What we have seen with test and trace over the past year is what the Tories want to do with the whole of our NHS. But this stealth privatisation does not end with test and trace. An unbelievable £100 billion has gone to non-NHS providers of healthcare over the last decade alone. Earlier this year, 500,000 patients had their GP services passed over to a US health insurance company, Centene, which is one of the biggest companies in the United States. Its UK subsidiary, Operose Health, now runs 58 GP practices and is thought to be the largest private supplier of GP services in the UK. It is no coincidence that Operose Health’s former chief executive officer, Samantha Jones, was appointed as an adviser to the Prime Minister. An adviser on what? An adviser on NHS transformation. Nothing to see here, of course.

The public have not consented to any of this. In fact, the Government have gone to great lengths to ensure that the public are not even aware that the process is happening, because a new poll by EveryDoctor showed that just one in four people know that up to 11% of the NHS budget goes to private companies.

Finally, when we consider the future of our NHS, we must tackle its staffing crisis. There are many tens of thousands of vacancies, including nearly 40,000 nursing vacancies alone. Yet NHS staff are set to get just a 3% pay increase this year, with most or even all of that increase being eroded by inflation. That will not only fail to tackle the shortages; it is a kick in the teeth, after everything—everything—that our NHS heroes have done over the past 18 months and after a decade of real-terms pay cuts. Nurses’ pay has fallen by around 12% since 2010, so the 15% pay increase that nurses are demanding would address that fall, even if it will not make up for the thousands of pounds in lost pay over the past decade. NHS staff have been balloted and they reject the current pay offer. I wish to place on the record that NHS staff have my full support in their campaign for 15%.

To conclude, instead of addressing the immediate crisis of 5 million people—and rising—on waiting lists, or the tens of thousands of staff vacancies, we are getting yet another top-down reorganisation, the aim of which is to accelerate the stealth Americanisation of our national health service. Of course, the Tories deny that their latest Bill is about privatisation and Americanisation, but I would argue that their response to the pandemic reveals their real ambitions.

[Hannah Bardell (in the Chair)]

Members will be aware that there will be a Division very shortly and the debate will be suspended. I would like to call winding-up speeches by 3.28 pm and I appeal to Members to speak for around five minutes.

[Chris Green (Bolton West) (Con)]

It is a pleasure to follow the hon. Member for Leeds East (Richard Burgon). He made a powerful speech, true to his beliefs and values, and he made some powerful points.

It reminded me of my more radical background when it comes to politics, especially in terms of health. I remember attending—not participating in—a demonstration and march in 2011 in Chorlton, shortly after the new Government came in. It was a reasonably left-leaning march and there were a few Soviet Union flags with the hammer and sickle. One of the most powerful contributions was from a trade union rep, who said, “We don’t need change. We don’t need innovation in the National Health Service. The only change you ever needed in the NHS was in 1948 when it was created. We don’t need any change from then.” That was the spirit, and it is the view that too many people have.

The NHS ought to be changing all the time, in different ways, to keep up with the way people work, and with technology and culture. There are so many ways in which the national health service ought to be changing all the time. We need legislation, led by my hon. Friend the Minister, to make sure that we keep up with changes in society. People would be outraged if we had not moved on culturally from 1948.

What does that lead to? Fundamentally, we ought to be focusing on the importance of patients’ values and needs, to make sure that they are at the centre of the national health service. It is not fundamentally about NHS structures, although those are incredibly important, or about maintaining structures as they are forever, but about ensuring that those structures reflect the needs of the national health service so that it is as effective as possible.

We hear discussions and talk about globalisation, which we know is a reality. Many parts of globalisation are a threat, as highlighted by the hon. Member for Leeds East, who talked about the threats and concerns. However, there are also significant opportunities. We want better access to drugs and medicines, especially innovative drugs and the latest drugs. If we look at figures from the European Medicines Agency about the adoption of drugs, we see that England is behind Germany, Denmark, Austria, Switzerland and Italy. We ought to be at the forefront of the adoption of new drugs and new ways to look after people’s lives.

What do we need to understand when we are thinking about this, especially when we consider treatments and support for people with rare conditions? The UK is often not big enough to provide the innovation for these new treatments, so we need international collaborations. The national health service and other UK bodies need to work with countries around the world, but there is a place for corporations, whether in America, Japan or other places.

We need to ensure that our research and development effort collaborates and works with countries around the world. That cannot be on a Government-to-Government or Government agency-to-Government agency basis only. It has to be right through the system. If we do not have that approach where we need clinical trials at scale to support people or to find new treatments for people with rare diseases, it will not happen. We need to participate in international trials as well.

I would expect these things and I hope my hon. Friend the Minister will articulate that they give more potential to the national health service, because we need more engagement. At the moment, the national health service does not function in the way that many people around the country believe it ought to function. It ought to be far more engaged in clinical trials. Talking to many people from the sector, my sense is that that is down to individual leadership in particular trusts.

Too many trusts do not lead and participate in innovation or the adoption of new drugs, once they have been approved. The system is too slow and it often takes far too long, so patients and patient groups know that their trust or clinical commissioning group does not have the life-enhancing or even life-saving treatment that is available. We need that reform of the system to ensure that it looks after the patients.

There is another aspect that needs changing, which is the way that the NHS is funded or operates. I have a strong sense that it is relatively straightforward for the NHS to adopt a new drug. However, it is far more challenging for the NHS to adopt a new medical device because of the up-front costs and the training needs at the beginning. It is more difficult to adopt a device than it is a drug, and we need to have parity in that. We need the NHS to have the ability to adopt these devices and adapt to them.

That naturally leads on to what devices do. A key part of devices is the generation of data. Data is important for understanding the performance and ability of new treatments to make a difference to people’s lives. The NHS does not operate, to any extent, as a system that works and engages properly and fully with data systems. We need reform of the NHS to do that.

[Hannah Bardell (in the Chair)]

Order. I hope the hon. Member will wind up his comments shortly.

[Chris Green]

I will. The integrated care systems ought to be part of this, with local leadership, and hopefully strong accountability, to ensure that leaders in those areas can drive that engagement with medical research technology charities, corporations, institutes and universities, to ensure that the NHS is innovative, adopts new technologies and ensures that patients have the best they can. That is a huge amount of reform, and it must start now.

[Rachael Maskell (York Central) (Lab/Co-op)]

It is a pleasure to serve with you in the chair, Ms Bardell. I thank my hon. Friend the Member for Leeds East (Richard Burgon) for opening the debate with so many facts that we need to reflect on. From before our first breath, to our very last, since 5 July 1948, the NHS has worked day and night to give us hope.

The principle was that, no matter who we were—duke or dustman, as Bevan said—we knew that, when the hands of the NHS reached out to us, it neither judged nor differentiated. It simply did everything it could to invest in our health. That equality was the way out of health inequality, which is, sadly, so stark today in constituencies like mine, where the most affluent can expect to live for 10 years more than the poorest.

Reading Michael Marmot’s report, there is something fundamentally missing from the NHS. This reorganisation will not address it. We must sew that into housing, air pollution, jobs—the things that really will bring about a fundamental change.

[Hannah Bardell (in the Chair)]

Order. I am sorry to interrupt the hon. Lady mid-flow.

--- Later in debate ---

On resuming—

[Hannah Bardell (in the Chair)]

Before I call the hon. Member for York Central again, I advise Members that the new end time for the debate will be 4.15 pm, and that I would like to call Ministers by 3.45 pm.

[Rachael Maskell]

Unless and until public health is the Government’s first priority, the demands will be ever-growing, but now, unlike before, it is uncertain whether those demands will be met. Just look at covid-19: the countries that put public health first had the lowest sickness and mortality rates, yet over 135,000 lives have been lost here. Whether it is covid or cancer, poverty is the greatest enemy of health, yet as we speak, the surge in poverty that this Government are imposing on our constituents through the changes they are bringing about—whether through national insurance contributions, or by taking away the £20 universal credit uplift and other benefits—is resulting in poorer mental and physical health. After a decade of austerity, poor workforce planning and a continued drive to profit off the sick have taken their toll on our NHS. In 2019-20, according to the King’s Fund, £9.7 billion was spent on private provision, up by £500 million on the previous year. According to the data provider Tussell, £37.9 billion-worth of covid contracts have been let.

The economic and health shock of covid should prompt us to hit the pause button on the NHS. Last Friday, I spent half a day with York Medical Group, with clinicians, managers, GP partners and support staff; I was there to listen. This Friday, I will be at York Hospital, which is also struggling. The GP practice has received 41,000 calls from a population of 44,000 patients on their books in a month; add to that the 5.6 million, rising to a possible 13 million, waiting for treatment in secondary care. The system is imploding, the staff are imploding, and the NHS is imploding. We cannot just keep feeding money into the NHS, and we cannot keep selling it off.

When I read the subject of the debate—“the future of the NHS”—I did not consider the Health and Care Bill to be that, nor did the staff who I met with. In fact, they see the Bill as a massive distraction from dealing with the current crisis that they are having to grapple with, and another assault is just one step too many. Staff are saying that to save their own mental and physical health, they are now having to walk. We therefore have a workforce crisis on top of a health crisis, and the NHS is now in a clinically dangerous place. Government Ministers who completely misunderstand how the NHS works cannot just keep interfering in the system. They need to pause. They misunderstand the professionalism, care, dedication and love of the people who give all that they have—day in, day out—to care for us. As Ministers introduce more complex systems and more private companies into the health service, the NHS itself is falling apart. The Health and Care Bill is not the solution; it cannot be the way forward.

On the integration of the health service and social care, if we do not put the money together, we cannot put the systems together. However, the reforms will create more barriers and more division, rather than solving the challenges before us. The World Health Organisation describes health as

“a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”

A future NHS must start here. Public health has been so underfunded over the last 10 years, and even under-utilised during the pandemic. It is absolutely vital that it is at the forefront of the future NHS. Regular population screening will start addressing severe health inequalities. Health counselling will ensure that people make the right choices about their future and will divert people who do not access the health service when they need it into early intervention and prevention. If we invest in clinicians in the community to undertake that dialogue and those discussions, and if we invest in social prescribing and other ways of improving people’s lifestyles, we have a real chance to turn this system around.

We cannot delay putting together an integrated public health agenda to drive forward our health service. If we continue as we are, our NHS will not be here. The pressures bearing down now are just indescribable. After listening to staff, all I can say is that the Health and Care Bill is just not the solution.

Covid-19 Update

Hannah Bardell Excerpts

Tuesday 14th September 2021 Commons Chamber

[Sajid Javid]

Yes, I agree with my hon. Friend, and he is right to raise this. I think everyone can understand why, during the height of the pandemic, GPs could not provide access in the normal way, but we are way past that now. Life is starting to return almost back to completely normal, and as that is happening it should be happening in our GP surgeries too. More GPs should be offering face-to-face access, and we intend to do a lot more about it.

[Hannah Bardell (Livingston) (SNP)]

The Secretary of State rightly speaks of the importance of vaccines, and Valneva in my Livingston constituency is playing a crucial role in the global fight against covid. Those at Valneva have worked incredibly hard to augment and adapt their work on a vaccine as new variants have emerged, as requested by his UK Government. So, Mr Speaker, you can imagine their shock and mine that its contract to produce 100 million vaccines was cancelled with very little notice or consultation. To compound that shock, there appears to be little clarity and reasoning, and while I will not repeat the rumours printed in the media, does the Health Secretary not agree that this is a shocking way to treat a company that is working tirelessly on a vaccine? Will he meet me to ensure that the future of this site, its work and its workers is secure, and will he rethink this disastrous decision?

[Sajid Javid]

I have to say to the hon. Lady that I do not agree with her. There are commercial reasons why we have cancelled the contract, but I can tell her that it was also clear to us that the vaccine in question that the company was developing would not get approval by the Medicines and Healthcare Products Regulatory Agency here in the UK, and obviously she is not recommending that we administer vaccines that do not get approval.[Official Report, 16 September 2021, Vol. 700, c. 10MC.] I do understand her point about Livingston and the factory there. That is very important to the UK Government and of course to the Scottish Government, and it is something we will be working on together to see what more we can do.

Do Not Attempt Resuscitation Orders: Guidelines

Hannah Bardell Excerpts

Wednesday 21st July 2021 Westminster Hall

[Hannah Bardell (in the Chair)]

Given the extreme heat, both in London and here in the Boothroyd Room, if Members want to speak or intervene without their jackets, that is permitted. I am sure the public will have sympathy. I have also advised the Doorkeepers that they may take their jackets off. Members will also be aware that social distancing is no longer in operation, but I remind them that Mr Speaker has encouraged us to wear masks between speeches and interventions.

[Martin Vickers (Cleethorpes) (Con)]

I beg to move,

That this House has considered guidelines for Do Not Attempt Resuscitation orders.

It is a pleasure to take part in this debate under your chairmanship, Ms Bardell. I will be fairly brief. I welcome the fact that hon. Friends have come along, and I am very happy to take interventions from them.

I requested this debate to raise the important matter of the use of do not attempt cardiopulmonary resuscitation and do not attempt resuscitation orders, which have been widely reported as being overused in recent years, particularly over the course of the covid-19 pandemic. I do not have a science or medical background. I am generally happy to defer to the opinions of the experts, who are far more qualified than me to speak about a patient’s condition. However, we have had a year of frequent and extremely worrying cases, some of which were highlighted by an article by Camilla Tominey in The Daily Telegraph on 12 June. I thank Ms Tominey for providing me with other articles. As a result of reading them, I felt compelled to raise this matter in the House today.

As a result of those reports, there are many people who have real concerns about this issue. Will they be consulted? I do not doubt that the medical professionals involved feel that they are doing their best and that they are acting in the best interests of their patients, but decisions of this kind must be made only after discussions with the patient or, if the circumstances demand it, their next of kin.

The Care Quality Commission published a report on 18 March following concerns raised at the beginning of the pandemic about the use of blanket DNACPR decisions across groups of potentially vulnerable people. It found that almost 10% of DNACPR decisions had been made and communicated inappropriately, involving potential breaches of the individual’s human rights.

Concerns have been raised by other Members during questions to the Prime Minister, the Leader of the House and the Health Secretary. Indeed, last week, when I questioned my right hon. Friend the Health Secretary, he said that a ministerial oversight group had been established to follow through on the CQC recommendations. I hope the Minister will be able to give more details about the work of that group. Many colleagues will have heard and read deeply saddening stories from constituents and citizens across the UK who have been impacted by this seemingly widespread approach.

Independent Medicines and Medical Devices Safety Review

Hannah Bardell Excerpts

Thursday 8th July 2021 Commons Chamber

[Emma Hardy]

Absolutely. One of the points that I will come to later is that people who have had rectopexy and hernia mesh implants have also been badly affected.

The recommendation that I want to focus on is the one that requires immediate action from the Secretary of State to set up an implementation taskforce to oversee the progress of the other eight recommendations, and to offer a timeline for the actions. Unfortunately, the Government declined the recommendation and instead offered the creation of a patient reference group to

“ensure that patients voices are heard”.

With respect, patients’ voices have been heard in the Cumberlege report. We already know that women are not listened to in the healthcare system. We need action to change that, rather than another review kicking the can down the road. I would be interested in hearing from the Minister how the Government intend to ensure that women’s voices are placed at the centre of their treatment when the patient reference group publishes its report.

[Hannah Bardell (Livingston) (SNP)]

Like others, I thank the hon. Lady for securing this vital debate. Does she agree with me that we need to encourage women to speak up and to support them to deal with their own health issues, but that comments made by some in Government recently that it is down to women individually to speak up can be unhelpful? We have to see this through the lens of the institutional challenges that women have faced for decades. Although we need to celebrate our clinicians, we really need to do more to educate them and give them resources and support to ensure women are not treated in the way the hon. Lady is describing.

[Emma Hardy]

I thank the hon. Lady for her intervention and I agree with her absolutely, which brings me on to the point about the redress agency, which is one of the recommendations in the report that has been rejected. Instead, the Government have said:

“The government and industry have previously established redress schemes without the need for an additional agency.”

That goes to the point that she made, because this puts the burden of redress in entirely the wrong place: on the victims, not on those responsible. Seeking redress requires enormous effort on the part of those who are already suffering, not just financially but emotionally, as was set out in Baroness Cumberlege’s report. It recommends that without waiting for the establishment of a redress agency:

“Separate schemes should be set up for each intervention…to meet the cost of providing additional care and support to those who have experienced avoidable harm”.

Sadly, no such moves have been made, so I would be interested if the Minister gave an indication of the progress on such schemes.

The report also recommends transparency on payments to clinicians, with a UK-style Physician Payments Sunshine Act 2010 to require the mandatory reporting of all payments made to doctors, teaching hospitals, research institutions and charities. The Government’s interim response said that they would “consider” this recommendation, in discussion with other parties, including the General Medical Council. I understand that there are suggestions that this could be done by expanding the voluntary system of reporting, but, as we have seen, voluntary systems simply do not work.

By way of a quick example, a high-profile academic recently admitted that he had failed to declare £100,000 from the manufacturer of one of the types of vaginal mesh implants that he was assessing. He has now published a correction, but this is almost seven years after he first did his report and it came only after a complaint was made about him. A section 60 order in the Health and Care Bill would allow for legislation to cover this, because transparency is vital to patient safety. There should be no opportunities for payments made by industry to introduce bias into prescribing or the scientific literature that is used to inform our National Institute for Health and Care Excellence guidelines. This report recommended creating a database to record which device was used when, in which person, and what the outcomes were in terms of safety and patient feedback.

The roll-out of the medical device information system has begun, but questions are arising as to what data is being collected. This is really important. To give an indication of that, let me raise the case of Kath, an extremely fit and healthy woman who used to be interested in skydiving. She had mesh implants and afterwards was in such pain that she was unable to move or get out of bad. This completely changed her life forever. However, her procedure was recorded as a success because she no longer had incontinence and that was the measure being looked at. We need to be looking at all patient outcomes when we are recording that data in those data sets.

That brings me on to my next point, which relates to the current moratorium on using mesh, as recommended in the report. Kath has said that there is no way she would ever have had this procedure had she had any indication of the risk of harm. I understand that there is pressure from some of the surgeons to reintroduce mesh, but I do not believe we can do that without fully informed consent, and we can have that only if patients are fully aware of all the risks. They can be fully aware of all the risks only if all the data is collected and recorded accurately. Until that is done, we cannot have informed consent and we should not consider lifting the moratorium on the use of mesh implants.

--- Later in debate ---

[Mrs May]

The hon. Gentleman is absolutely right and I shall come to the issue of redress in relation to these particular aspects of pelvic mesh, sodium valproate and Primodos and other HPTs. I was making the general point that I see constituency cases of individuals where a mistake has been made by the NHS. They want an apology and to know that change is going to take place, but they come up against a brick wall and sometimes find themselves battling and ending up in court to try to get some redress—with all the problems that that creates—because the institution has defended itself, rather than taking the patient’s voice seriously.

Our NHS does amazing work day by day and it has done amazing work during the pandemic, but, sadly, when mistakes are made, it does not always respond in the right way. The report of the independent review made this very clear:

“There is an institutional and professional resistance to changing practice even in the face of mounting safety concerns. There can be a culture of dismissive and arrogant attitudes that only serve to intimidate and confuse. For women there is an added dimension—the widespread and wholly unacceptable labelling of so many symptoms as ‘normal’ and attributable to ‘women’s problems’.”

It went on:

“Mistakes are perpetuated through a culture of denial, a resistance to no-blame learning, and an absence of overall effective accountability.”

It was apt that the report was called “First Do No Harm”; as the noble Baroness Cumberlege said:

“It is a phrase that should serve as a guiding principle, and the starting point, not only for doctors but for all the other component parts of our healthcare system. Too often, we believe it has not.”

Like the hon. Member for Kingston upon Hull West and Hessle, I am concerned that the Government have not responded to and accepted the recommendations of the review in full. The recommendations were not made lightly; they were made after listening to considerable evidence and hearing the voice of people who had suffered for years as a result of the use of these medicines or medical devices. The report identified where changes needed to be made. Of course responses take time and of course the Department has been dealing with the pandemic, but I hope that the Government are going to respond properly on all the issues raised.

The Government have agreed to set up an independent patient safety commissioner—partly, I have to say, because of the action in the House of Lords in relation to amendments to a Bill—and they are now consulting on the position, but we do not know when the commissioner is going to be in post. The commissioner is important, because it is the commissioner who will enable the user’s experience—the patient’s voice—to be heard. By hearing that voice, it will be possible to detect and stop the use of medicines and medical devices that lead to avoidable harms.

[Hannah Bardell]

The right hon. Lady has made the point about institutional cultures, defensiveness and the culture of litigation that it feels like we have now got into, particularly in respect of some aspects of the health service. Does she agree that the patient safety commissioner must have teeth and must be able to help us—I think there would be agreement across this House and in the other place on this—to try to move away from that culture so that we can learn from mistakes?

[Mrs May]

I absolutely agree about the importance of the patient safety commissioner; they have to be able to do the job that is intended and set out for them to do. I know that there will be those who will be concerned that their sponsoring Department is the Department of Health and Social Care. It is natural because this is a health issue, but I hope that the Department will make every effort to ensure that it cannot be accused of trying to water down the role of the independent safety commissioner, because, as we are saying, it is important for the user’s experience to be heard. This is not about trying to get at the Department of Health or the NHS or anything. It is about people who are suffering real-life experiences and impacts as a result of the use of medicines and medical devices; it is about identifying those situations and ensuring that action is taken to stop them happening so that others can be protected.

The issue of redress was mentioned by the hon. Member for Kingston upon Hull West and Hessle and the hon. Member for—I apologise, because the hon. Gentleman is in the House so frequently, but I have forgotten his constituency—[Interruption.]. Strangford, thank you. The issue was also mentioned by the hon. Member for Strangford (Jim Shannon). The Government have said that an agency is not needed, yet time and again the only redress for patients is through recourse to the courts. That is expensive and stressful. It is also expensive for the national health service; in 2018-19, the NHS paid £2.4 billion in clinical negligence claims. But redress is about far more than compensation. It is about relating to the real impact that the use of these medicines and medical devices has had on people, such as the need for special education for children who have been affected because their mothers have taken sodium valproate when pregnant. There are many other examples. I urge the Government to look again at that issue.

I also want to raise the issue of the patient’s voice, because this has all been about an unwillingness in the past to listen to the patient’s voice. Setting up the patient reference group was fine, but I understand that it is due to publish findings shortly, and nobody knows whether the patient’s voice is going to be taken into account or how it can be in the future. I urge the Government to ensure that patients are part of the implementation; it is their experience that we are talking about, so it is so important that they are included.

My final point relates to sodium valproate and it partly comes from constituency experience. This medicine has a one in two risk of causing harm to a baby if a woman is taking it while she is, or becomes, pregnant. What lies behind this issue is information and education, but it took a year for the Government to write to women to raise awareness of the risk. I hope that the Government do not think that that is job done, because this is an ongoing issue that has to be addressed. It is not just about providing information to women; it is also about ensuring that their clinicians are well informed when they are prescribing and dealing with their cases.

Women suffered considerably from the use of pelvic mesh, from hormone-based pregnancy tests, predominantly Primodos, and from sodium valproate, but they and their children are still suffering today. At the heart of this situation lay a health system that, in the words of the report, is

“not good enough at spotting trends in practice and outcomes that give rise to safety concerns. Listening to patients is pivotal to that.”

The system did not listen. It saw real pain and debilitation as women’s problems. The service which at its heart has our safety and protection ignored concerns over safety for too many years. The independent report recommends steps for the system to change. I urge the Government to embrace the recommendations in full. That way, we will be on the way to ensuring that we have a system that genuinely first does no harm.

--- Later in debate ---

[Hannah Bardell (Livingston) (SNP)]

I am grateful for the opportunity to speak in such an important debate. I congratulate, again, the hon. Member for Kingston upon Hull West and Hessle (Emma Hardy) and it is a pleasure to follow the right hon. Member for South West Surrey (Jeremy Hunt). It is rare in these political times that this House is united on an issue, but it is united today, more than I have seen it for some time. I hope to speak directly for a moment to those out there who are watching who have been affected by hormone pregnancy drugs such as Primodos, like my constituents Kirsteen and Wilma Ord, or sodium valproate or vaginal mesh, or mesh that is used in men: this House is united and there are Members in this place who will not give up the fight to make sure that you get justice and redress.

I want to talk specifically about families affected by Primodos. I pay tribute to Baroness Cumberlege and I am very pleased that she is here today. She and her team did an incredible job on her review, “First Do No Harm”. I pay testament to the bravery, dedication and passion of the Primodos campaigners, led by Marie Lyon. She is the personification of persistence and I know that she will be watching, because it is unimaginable that families and victims of Primodos had been subjected not only to the harm of the drug, but years and years—decades—of waiting and campaigning. We have to recognise, as Members including the right hon. Member for Maidenhead (Mrs May) did, that it is so damaging that these things can take so long. They are corrosive and debilitating—I have seen that in my constituents.

Time and again, we see families treated this way, whether they are the victims of thalidomide, contaminated blood, the families of Hillsborough or now the victims of Primodos, sodium valproate and medical mesh. There have been years of inquiries and public money is being spent for those who have suffered and are still suffering, and very often, they do not get justice or have to wait for decades, or they and their family have died before they have the truth. It is a culture of kicking the can down the road and it is toxic.

One key thing, particularly in relation to Primodos, is the guilt that those women live with—that they somehow were responsible, and have been told by doctors that they were responsible, for the harm of their own child, which we all know is absolutely incorrect and not true. I hope that any family, any victim and any woman affected, particularly by Primodos or, indeed, sodium valproate or mesh, know that it is not your fault. You did not do anything wrong.

The Cumberlege review was a huge step forward in recognising the unnecessary and colossal harm inflicted on victims of the Primodos drug. The review was supposed to mean that victims had finally been heard and believed and I think that many, many felt that they had been. After it was published, the Conservative Government made a very welcome and long overdue formal apology to victims, and I pay tribute to the former Health Secretary, the right hon. Member for South West Surrey, and the former Prime Minister, the right hon. Member for Maidenhead, for their part in the work that they have done in that area.

However, we need to be reminded, and those now in power need to be reminded, that an apology means nothing if the action to rectify those issues and make sure they cannot happen again does not happen. Only two of Baroness Cumberlege’s nine recommendations have been implemented. Given that these families—the Primodos victims—have waited almost 60 years, including my constituent Wilma Ord and her daughter Kirsteen, they cannot be forced to wait any longer, surely. An apology and a patient safety commissioner is a big step forward. In Scotland, we have also brought forward a review and intend to bring forward those plans, and I am sure that we will continue to work with this Government and the Health Secretary to make sure that we do all we can in Scotland.

The injustice continues, however, because the families have not received the compensation or lifetime care that was rightly awarded to thalidomide victims earlier this year. Like thalidomide victims, Primodos survivors face constant uncertainty about the cost of their care as they get older. Many surviving victims are now in their forties and fifties, and they are facing physical challenges with their bodies. Many have relied on care from their parents who are now getting older and facing their own challenges. That is truly heartbreaking.

My constituent Wilma Ord has spoken very candidly to me about the burden she feels, and the fears she has for her daughter as she gets later into her life and may not be able to cope. She worries about what will happen when she has gone. She just wants to know that her daughter will have the support she needs. I do not think that that is very much to ask. Financial support for these families is the least they should be offered. That should just be the starting point in addressing the harm that was done to them. Thalidomide campaigners did not have to obtain proof of a causal link in their fight for justice and rightly so, so why is there a higher bar set for Primodos victims before the Government will provide equal treatment? I hope the Health Secretary can answer that question.

The UK Government repeatedly cites—we have not spoken about this yet, I do not think—the 2017 expert working group report. Its failings have been widely acknowledged. Having worked closely with the hon. Member for Bolton South East (Yasmin Qureshi), who has done a huge amount on this issue, and campaigner Marie Lyon who sat on that group, we know the expert working group was not only a whitewash but a disgraceful waste of public money. There are serious questions around the process and independence of that report, but we want to move forward.

[Yasmin Qureshi (Bolton South East) (Lab)]

The hon. Lady mentions the expert working group’s report, which was, as she rightly says, universally panned in this Chamber. The interesting thing is that the Cumberlege review took place after the expert working group. It had a look at the report and also came to the conclusion that it was not worth the paper it was written on.

[Hannah Bardell]

I thank the hon. Lady for her intervention. She makes an excellent point. We know there were serious questions around the process and the independence of the report. I remember going with her across the road to the conference centre where it was being launched, and being denied entry. Two democratically elected Members of Parliament working for our constituents were refused entry to the launch of a report funded by public money. It was an absolute scandal.

The evidence uncovered by Sky News reporter Jason Farrell suggested that significant sections of the original draft were changed before publication, including the omission of a graph showing that the majority of historical studies found an association between the drug and malformations. In short, evidence was deliberately omitted and censored, and Government money was spent on that. You know the worst of it? Families and victims were strung along for months and months and months only to be let down. That can never happen again.

If the Government seek to rebuild trust after such devastating scandals as Primodos, they must give the public and most of all the victims a fair and open process. That cannot be achieved, however, if it relies on a report and findings that are not fit for purpose. Everybody in the House knows that and the public know that. How many times are we going to see public money spent on placating people, while report after review gathers dust on a shelf rather than action being taken? Processes have to be open and robust. When they are and when reports such as Baroness Cumberlege’s report are produced, they have to be put into action. It is vital that that now happens and that we find a way forward for Primodos victims, and for the victims of sodium valproate and mesh.

All the failings in the system that led to this awful situation are in the past and cannot be undone, but we have to be sure that the public have confidence not just in their medical practitioners, who have done a phenomenal job through covid, but in the processes and in our ability as parliamentarians to do our job. Now, in 2021, why are the Government continuing to perpetuate that wrong? They are compounding the pain and suffering that the families have endured at the hands of the state’s failure to regulate private pharmaceutical companies properly. It feels very much like profit over people. We do not want to hear, and I know that my constituents do not want to hear, “We’re in litigation; we’re engaged in a legal process.” That is all very well, but the Government have a duty to implement the recommendations of the report that they commissioned.

All I would say to the Minister and the Health Secretary is that they have the opportunity to right a wrong. Let us not continue down the road of defensiveness and turning our back on those victims who have waited decades—literally lifetimes—to get answers and justice. Ministers should do the right thing and give them the justice and the recompense that they deserve.

Oral Health and Dentistry: England

Hannah Bardell Excerpts

Tuesday 25th May 2021 Westminster Hall

[NB: [V] denotes a Member participating virtually.]

[Hannah Bardell (in the Chair)]

I remind hon. Members that there have been some changes to normal practice in order to support the new hybrid arrangements. Timings of debates have been amended to allow technical arrangements to be made for the next debate. There will be suspensions between debates. I remind Members participating, physically and virtually, that they must arrive for the start of a debate in Westminster Hall and are expected to remain for the entire debate. I must also remind Members participating virtually that they are visible at all times, both to one another and to us in the Boothroyd Room. If Members attending virtually have any technical problems, they should email the Westminster Hall Clerks at [e-mail]. Members attending physically should clean their spaces before using them and before leaving the room. I remind Members that Mr Speaker has stated that masks should be worn in Westminster Hall.

--- Later in debate ---

[Sir Paul Beresford (Mole Valley) (Con) [V]]

I am delighted to serve under your guidance, Ms Bardell. I congratulate the hon. Member for Bedford (Mohammad Yasin) on obtaining this debate. His speech was a barrage of negativity, and it is not all negativity in this field. I am a practising dentist—part-time at the moment; very little. I am a member of the British Academy for Cosmetic Dentistry, the British Fluoridation Society and the British Endodontic Society. That is wet-finger dentistry, though in a glove.

For decades, the dental profession, especially NHS dentists, has felt that dentistry as a health service has, as far as the Department is concerned, been seen as a Cinderella service, or an expensive minefield, or both. This has gone on for decades under Governments of various and even mixed complexions. However, I believe this has markedly improved with my hon. Friend the Minister and the current chief dental officer. There has been a visible change of attitude. Both ladies recognise the importance of improving the oral health of the nation and of the status of dentistry as a health service. To use the chief dental officer’s banner statement, at last

“Putting the mouth back in the body”.

Covid has had a dramatic effect on the ability to provide dental services, whether NHS or private. Waiting lists for all dental patients have dramatically exacerbated, and we have just heard a tirade on this. Covid meant that for a period all dental surgeries were closed. Only emergency services and specialised clinics were open. When the surgeries were permitted to start resuming covid protection, actions such as furloughed time, PPE and so on added to the delays, complications and diminished throughput. Clinical teaching of final year students was diminished, such that there is doubt that some of them are ready to graduate.

All the dental team should have been double vaccinated by now, whether private, mixed practices or NHS. The R factor is going down. An increasing proportion of patients have been vaccinated. Dentists are following a careful triage system. Deaths are down, hospitalisations are down and the 21 June release is still on, we hope.

My hon. Friend the Minister can see my request coming like a big balloon because I have already discussed it with her. The time has come for a road map to release dentists from PPE and all the restrictions. We need a return to the pre-covid treatment of patients and we need SAGE to look at it and get on with it. That will be the biggest single action in enabling dentists to get this backlog into line.

My second wish is a push at an open door with the Minister. Dental care is preventable, but while there has been progress, we are badly behind, especially in caries prevention for children. Pre-pandemic, these children occupied 177 clinical general anaesthetic extraction cases in hospital—a complete waste of our services. The latest figure that I have seen is that 23,529 children between the ages of five and nine were admitted to hospital because they had tooth decay.

I first started practising dentistry in a deprived area in east London. The state of dentition there shocked me, especially the state of children’s dentition. It was not the deprivation that caused the poor dentition; it was the diet and the almost complete lack of oral hygiene. Put simply, kids and parents did not toothbrush. Some parents did not even know that toothbrushes existed. And if you went into the supermarket, the shelves were packed with biscuits and cakes, whereas there was little meat or vegetables; go to less deprived areas and it is the other way round. So, it is not the deprivation; it is the shoppers—the parents.

The Minister will know where I am going with this. She and the chief dental officer are already embarking on teaching children in teams throughout the country to brush their teeth. Coincidental with this, most children are accompanied by their parents, some of whom are stunned to see this little thing called a toothbrush. But the message is getting through; as the hon. Member for Bedford said, we are starting to get some progress, and it is happening quite quickly.

As I have said, tooth decay is essentially highly preventable. Water fluoridation is the single most effective public measure that could be taken to prevent tooth decay. At the moment, implementation of fluoridation is in the power of local authorities. Little progress has been made. We lag behind every other western nation. Most of our western nation comparators have a fluoridation rate of domestic water supplies of between 60% and 80%, but we have a rate of only 10%. It is the system; the costs are to the local authorities and the cost-benefits are to the national health service.

The process of consultation over fluoridation is lengthy and tedious, and it is providing a platform for protesters of the same type as the anti-vaccination people. Some of the things that they say are quite extraordinary. I had to listen to a man explaining to me that he had done some research. He said that he had been to a town with young people and no fluoride, and to a town with older people with fluoride, and the venereal disease rate in the town with young people was higher than that in the town with older people. Therefore, according to him, if we put fluoride into the water supply, people got venereal disease. And to my astonishment, there were other people there who actually believed that nonsense.

To make a more practical point, there are considerable difficulties for both local authorities and water companies, in that their boundaries are rarely, if ever, coterminous. So, it makes eminent sense for the implementation process for the new schemes of fluoridation to be put in the hands of central Government and driven by central Government, which is the Minister’s proposal.

In doing so, however, I hope that the Government will curtail the procedures on consultation. In every period of consultation, in every place of consultation, the same thing is said by the same people, and I believe that the same nutters come out. If we continue with that process, we will have a repetition of the scaremongering stories from people who are basically cranks.

The safety, efficiency, cost-effectiveness and benefit of fluoride in water supplies, whether it is achieved naturally —as is the case in many parts of the world—or artificially, is proven to be workable and to achieve dramatic reductions in tooth decay. With this proposed step and the Government’s determination, rather than our lagging behind the rest of the world we could actually lead, and I hope that we move to do so.

[Hannah Bardell (in the Chair)]

Before I call the next speaker, I ask Members to keep their remarks to within eight minutes, to allow equal time, and I hope to call the Opposition spokespersons by 10.35 am.

--- Later in debate ---

[Rachael Maskell (York Central) (Lab/Co-op) [V]]

Thank you, Ms Bardell, for the opportunity to speak in today’s debate with you in the Chair. I thank my hon. Friend the Member for Bedford (Mohammad Yasin) for putting the debate into context. Here I am again debating dental services with the Minister and, yet again, championing the needs of my constituents and the dentists who have worked relentlessly throughout this pandemic in extremely difficult circumstances.

York had a dental crisis before the pandemic. Constituents now tell me that they have to wait at least three years to receive NHS treatment and that those trying to register struggle or simply search for treatment outside the area. We have serious problems in York, as the Minister knows. NHS treatment needs to be available for all and, tragically, it is not. Many are now turning to accident and emergency services to get pain relief or a course of antibiotics. Private care is not an option, nor should it ever be.

Successive Ministers have failed to address this crisis. This month, the Minister was unable to tell me, as my hon. Friend the Member for Stockport (Navendu Mishra) has said, how many NHS dentists there are in my city. The fact that she does not have that basic data gives me little hope that the Government have really got a grip on the scale of this crisis and the needs that must be addressed.

It is perplexing that oral health is seen to be different from other areas of healthcare, and that we have to pay for things that are done to our mouths but not to the rest of our bodies. It did not start that way. When Nye Bevan established the NHS, dentistry was free at the point of need and everyone was entitled to have their check-ups and treatment on the NHS. It was transformative. In 1951, the first assault on our NHS occurred when charges were introduced. That caused Bevan to resign in disgust, and sadly since then the divorcing of oral health from the rest of medical care has failed to serve us well.

Evidence from the BDA—I thank it for the work it does—shows that the pattern of health inequalities in other areas of healthcare is reflected in dentistry and oral healthcare, so it is time for integration, not segregation. Although I understand the point that the hon. Member for Mole Valley (Sir Paul Beresford) made, he did not suggest a solution. Of course, we need to ensure that good-quality, healthy food is available for all, particularly those living in deprivation, but it is wrong to blame those individuals for their lack of choice due to their financial circumstances.

This patchwork of failed contracts has courted privatisation and created a dependency on labour from other countries which, simultaneously, this Government are spurning. In the past year, I have been on a journey with many of York’s dentists to learn why, unless we see radical change to the delivery of dental services, the system will collapse. Dentists will burn out or leave—indeed, they are doing so as we speak—and the nation’s oral hygiene will deteriorate further. Even during the pandemic, dentists have been told that they will be penalised if they fail to deliver unrealistic contractual targets while practising in a covid-risk environment.

The NHS dental contract fails to pay. The Minister sets unrealistic targets—units of dental activity—without consideration of the scale of the barriers that dentistry is facing, and without providing mitigation. Ministers in Wales, Scotland and Northern Ireland seem to have understood that, but this Minister has not. In a post-covid world, and against a backlog of more than 20 million appointments—think about the scale of that; we are rightly exercised by the 5 million outstanding secondary-care appointments that we are having to grapple with at the moment—it is baffling that the Government have failed to grip the scale of this deepening crisis and have not instituted an emergency service.

The tightening of the thumbscrews on dentists through their contracts shows no mercy, despite their call for ventilation equipment funding, high-grade PPE and an understanding that requiring treatment rooms to lay fallow before a deep clean can commence due to the aerosol- generating procedures eats into dentists’ ability to deliver their contract obligations. The arbitrary, unevidenced targets require dentists to work round the clock, cancel leave and often their whole lives. They force dentists to focus on high-volume, low-risk work such as check-ups, while patients requiring treatment, not least complex treatment, are made to wait. It is unethical and wrong.

To top it all, the Government’s net spend on dental services, as we have heard, has been cut by more than a third in the past decade. Evidence shows that every pound invested can save over three, as well as teeth. This is the moment to start again, and I am glad the Minister is in listening mode. We have the diagnosis. We know the problems and the scale of the challenge. It is not time to tweak locum contracts or drive our dental staff harder. It is time to get a real, pragmatic solution in place. There is an opportunity to legislate for a national dental service in the forthcoming health and care Bill to solve this problem.

Oral health should be seen as a public health matter. It should attract the planning and preventive approach that any other public health emergency would. Fluoridation, as we have heard, is a no-brainer and brings universal benefits. I urge the Minister to introduce that without delay and end the postcode lottery. A principle needs to be made that everyone should be able to receive free oral health at the point of need—no barriers, and no excuses. Good oral health has to be accessible for all—nationally determined on the what, and locally determined on the how. We need to increase significantly the number of training places for dentists in the UK and ensure that the benefit they gain from training is tied in with their commitment to serve in a national dental service under NHS terms. Training bonds are not unique, and they ensure reciprocity. Therefore, they will bring real benefit to the service. What plans has the Minister executed in order to train more dental staff and ensure that we have sufficient numbers in our dental schools? What discussions are taking place? We would like to know.

Delivery is something that this pandemic has taught us all about. We need a collaborative approach—a place-based system approach—to ensure that we address the scale of the issues. The vaccine programme has settled the debate about emergency provision once and for all, and we are in that space now with dental care. Every child and young person should be able to access dental inspections in school each year, and this should be routine from when children start school. Early prevention would not only save the NHS a lot of money; it would also save children a lot of trauma.

Similar plans could be put in place for care homes. For adults, an accessible check-up service would clear the backlog and enable cases to be triaged, population-wide, into treatment. For some people, light treatment could be provided simultaneously, with more complex cases referred to a booking system.

As we have seen with this pandemic, there are collaborative ways to address health crises. A place-based approach, whereby barriers can be removed, can be enabled to provide the solutions. Rather than struggling to design ever-more challenging contracts and systems to serve a fair model, the Minister could create a national dental service and use this framework to work with local delivery partners. In a matter of months, she could start turning this vital service around for all.

[Hannah Bardell (in the Chair)]

Before I call the next speaker, may I gently and politely remind Members to turn off their phones or put them on silent during the debate?

Covid Contracts: Judicial Review

Hannah Bardell Excerpts

Wednesday 24th February 2021 Commons Chamber

[Edward Argar]

I am grateful to my hon. Friend, and like him, I pay tribute to all those businesses and individuals who stepped up in this country’s moment of need, and were willing to put themselves forward and repurpose their factories to try to find ways to help that the national effort. All the contracts have been found so far to be awarded entirely appropriately; there has been no adverse judgment in respect of any of that. Indeed, regulation 32 highlights that in an emergency, contracts can be awarded without tender, and I certainly take the view that the situation we face with this pandemic constitutes a national emergency.

[Hannah Bardell (Livingston) (SNP) [V]]

Can the Minister tell me whether it is coincidence, incompetence, or just rank stupidity that his Government and Health Secretary awarded a £30 million contract for testing vials to the Health Secretary’s former neighbour, a former pub landlord who had no experience in this field and is now being investigated by the Medicines and Healthcare Products Regulatory Agency? Surely, the Minister agrees that these breaches mean the Health Secretary must resign.

[Edward Argar]

The hon. Lady will not be surprised to know that I completely and utterly disagree with her. I think my right hon. Friend has done, and continues to do, an extraordinary job under extraordinary pressure to help this country through this pandemic over the past year.

The hon. Lady raised a very specific issue. It has been made clear that neither the Health Secretary nor any other Minister had any involvement in the assessment, the due diligence, or any decisions in respect of that contract.

Vaccine Roll-out

Hannah Bardell Excerpts

Thursday 21st January 2021 Commons Chamber

[Matt Hancock]

I agree with every word that my right hon. Friend said. I am really pleased that this week Brand Russell pharmacy in East Barnet is opening for vaccinations, and we are accelerating the amount of vaccinations in London, which is the region in England that has the most to do.

[Hannah Bardell (Livingston) (SNP) [V]]

I fully appreciate and respect that the Joint Committee on Vaccination and Immunisation has a very strict protocol for the roll-out of vaccines, but have it and the Secretary of State considered the notion that staff working to develop and produce vaccines, like those at Valneva in my constituency, should get a vaccination as soon as possible? Will he give some consideration to this and discuss it with the JCVI? I will be writing to him shortly.

[Matt Hancock]

I will consider that request given the importance of the vaccine supply, which is critical for everybody else to get their vaccinations too.

Independent Medicines and Medical Devices Safety Review

Hannah Bardell Excerpts

Thursday 9th July 2020 Commons Chamber

[Ms Dorries]

I pay tribute to my right hon. Friend, who commissioned the review in 2018. Thank goodness he did, because without it, these voices would still be struggling to be heard.

On my right hon. Friend’s question about the patient safety commissioner, as that is a recommendation, it will be considered, as will every other recommendation. It is important to mention that we have Aiden Fowler, whom my right hon. Friend appointed to NHS Improvement to take on the head of patient safety role on behalf of NHS England. That does not mean that we will not consider the recommendation thoroughly; we will do so.

Obviously, I cannot speak for the Secretary of State, but I am sure he is aware of my right hon. Friend’s comments. I cannot commit to coming back by the end of September; what I can give the House is my absolute assurance that I will chase this daily. The work commenced when the report became available to us, and a huge amount of work has been done overnight on assessing the recommendations made in the report. I or the Secretary of State will be back here as soon as possible with our recommendations.

[Hannah Bardell (Livingston) (SNP) [V]]

I thank the Minister for advance sight of her statement. Of course, her apology is very welcome.

“We have found that the healthcare system—in which I include the NHS, private providers, the regulators and professional bodies, pharmaceutical and device manufacturers, and policymakers—is disjointed, siloed, unresponsive and defensive.”

Those words in “First Do No Harm”, the report published yesterday on the Primodos, sodium valproate and pelvic mesh scandals, are a hugely powerful indication of the abject failings that must be addressed by the Government. Credit must go to Baroness Cumberlege and her team for all their work.

Yesterday was a landmark day for victims and survivors of those scandals, and we pay tribute to all the campaigners who fought so hard for so long, including Primodos campaigner Marie Lyon and my constituent Wilma Ord, whose daughter Kirsteen was affected by Primodos. Their fight must now be our fight.

Justice is not served until the recommendations are fully implemented. I understand the desire and the need to reflect on what is needed, but a full commitment to the implementation of all the recommendations is vital. In particular, will the Minister ensure that the taskforce to guide the recommendations is set up at speed and as soon as possible? Will she also commit to vigorous pressure being exerted on companies such as Bayer, which, to be frank, have got away with murder? They are responsible for Primodos and need to pay proper compensation to victims.

Will the Minister ensure that the recommendation of a patient safety commissioner is implemented and the post established as quickly as possible? In the words of Branwen Mann, a young person affected by sodium valproate,

“I know that the full harm done by sodium valproate is barely understood, or even recognised by anyone other than the family that live it.”

That cannot continue.

Finally, will the Minister ensure that the central patient identifiable database is created by collecting details on the implantation of all devices at the time of operation? So many patients affected by surgical mesh and other devices have never had their devices tracked or registered, which in the age of advanced technology is, I am sure she agrees, frankly ridiculous.

[Ms Dorries]

Again, that is a list of asks, and as I said in my reply to the hon. Member for Nottingham North (Alex Norris), we will take on board all the requests made and come back in time with a full report.

On the hon. Lady’s last ask, about the database, we have begun working with NHSX on establishing a database of those women who have had the vaginal mesh. We are looking at how those meshes can be safety removed, with their consent and with all the details explained to them. Getting that database together, both historically and moving forward, is work in progress. On the rest of the hon. Lady’s asks, we will be back with a full report, in which all of her points will have been considered.

Lesbian, Bisexual and Trans Women’s Health Inequalities

Hannah Bardell Excerpts

Tuesday 10th March 2020 Commons Chamber

[Hannah Bardell (Livingston) (SNP)]

I beg to move,

That this House has considered lesbian, bisexual and trans women’s health inequalities.

It is a pleasure to move the motion and to speak in this very important debate on lesbian, bisexual and transgender women’s health in the week we have been observing for considering such issues. The aim of the LBT Women’s Health Week is to raise awareness about lesbian, gay, bisexual, trans and queer women’s health inequalities, to make it easier for service providers to empower service users and to make it easier for communities to support LGBTQ women.

Up front, I will declare an interest as a lesbian, who also suffers from anxiety and other mental health issues. I know that my own experiences have taught me a huge amount. In recent months and years of reflection since I came out in 2015, I have had a little bit of time, despite the political storms we have lived through in recent years, to reflect on some of the reasons why it took me so long to come out.

I am very grateful to the Backbench Business Committee for granting this debate, and to the many charities and organisations that operate in the LGBTQ space that have provided briefings for today, as well as our healthcare professionals—I know we will discuss them today, but we must pay tribute to them—and to the Women and Equalities Committee and the Parliamentary Office of Science and Technology, which have done much work and produced reports that many of us will draw on. I know some controversial issues will be discussed today, but I am certain that we will hold this debate and have our discussions with respect and integrity.

I also want to thank the many folk who contacted me after I put a shout-out on social media asking for lesbian, bisexual and transgender women’s experiences of health inequality. I am sure that everybody in this House will agree on the ills of social media, but I also hope we can agree that there are times when it can be incredibly positive and constructive as a tool to help us engage. At a time when this Parliament and the politics of this place can seem very far from folks’ lives, I have appreciated the ability to reach out to the public via Twitter and other social media channels, and I will shortly share some of the experiences that members of the public have shared with me on this issue. I know that some of them were very painful and very difficult to relive and to recount.

There are many facets to the debate on the healthcare of LGBTQ people and women in the LGBTQ community, and the fact that there is a specific week to raise awareness when there are so many other issues going on is really helpful. The Science and Technology Committee report states that there is

“emerging evidence demonstrates that lesbian, gay, bisexual and trans (LGBT+) people experience significant health inequalities across their lifespan, often starting at a young age.”

I came out literally as I was being elected, initially to myself, then later to my family and friends and publicly sometime after that, and that was challenging. It is fair to say that the impact on my mental health was profound. As most of us who have been here since 2015 will know, there was not exactly time to process any personal challenges or issues. But my experience of coming out publicly was hugely positive. Social media played a part in that, such as taking part in a photograph of LGBTQ MPs and peers, which then went online and attracted much attention; that showed the solidarity not just in this place and at the time in the other place for LGBT politicians, but across wider society. It was hugely positive, but I am also very conscious that I had an incredibly supportive network of family and friends, and that I have a very privileged position; in many ways I came out with the cover of political privilege. That is something that very few other people across the UK and beyond have, and we must always remember the challenges that folk across the UK and beyond face in coming out and those in the many countries where it is still illegal and people are persecuted for being LGBTQ.

[Christine Jardine (Edinburgh West) (LD)]

Does the hon. Lady feel that at this time we should include in our thoughts those lesbian, bi and trans women who are asylum seekers and have been asked by this Government to prove that?

[Hannah Bardell]

I absolutely agree with that. There are a number of stories in the press at the moment about LGBT asylum seekers that are hugely concerning, and I would like to think that, given the distance we have travelled, this Government will review their processes and policies and look very carefully at the treatment of LGBT asylum seekers. I have met a number of them myself, and some incredibly important work is ongoing, but the stories that we are reading in the press and the experiences that we are hearing of LGBT asylum seekers are deeply troubling, and I absolutely agree with what the hon. Lady said.

On coming out later in life, I discovered recently that middle age is classified as being between 30 and 50. I have to say that that was a shocking discovery.

[John Nicolson (Ochil and South Perthshire) (SNP)]

It is middle youth.

[Hannah Bardell]

I agree with that.

For me, and for many other people, in coming out later in life there is an element of regret, and in fact mourning, for a life not lived as my authentic self, and it is hard to describe what that feels like. I try very hard to look forward—to make the most of what is in front of me, not to look back and have regrets that I was not living my life as my true self. There are many reasons why people come out later in life, and there is also much research around the profound impact that that has on people’s mental and physical health.

Coming out as lesbian, gay or bisexual can be a very different experience from coming out as trans. I cannot imagine how incredibly difficult that is, particularly in the current climate. We owe it to our trans and non-binary citizens to support them and ensure that discussion around changes in legislation or any matters relating to their lives and healthcare is conducted in a respectful and decent way. Sadly, I think we can all agree that there have been times recently when that has not happened.

[John Nicolson]

Does my hon. Friend agree that while it now seems socially unacceptable to express anti-gay thoughts and feelings, by contrast we appear to be having an open season on trans people, which is deplorable. Does she also agree that that must be deeply disturbing for young trans people who are trying to come to terms with who they are?

[Hannah Bardell]

I absolutely agree. Technical details of legislation and the concerns that people may have can and should be discussed, but they have to be discussed in a respectful way. As my hon. Friend says, there is open season on trans people. We could literally cut and paste some of the rhetoric that was used against lesbian, gay and bi people the ’70s and ’80s. That it is now being used against trans people is just utterly deplorable. We must do everything we can to protect trans and non-binary people’s rights and their mental health.

We know the LGBT community, including lesbian, bi and trans women, experience significant health inequalities and specific barriers to services and support. Stonewall Scotland’s survey of LGBT people in Scotland found that half had experienced depression in the past year, including seven in 10 trans people, and that more than half of trans people have thought of taking their own life in the past year. Let us just reflect on that. Half of trans people have thought of taking their own life in the past year. So when we think about and reflect on the debate that is currently ongoing, we must look at that statistic and take it very, very seriously.

[Bob Stewart (Beckenham) (Con)]

The hon. Lady refers to half of trans people. Can she put a figure on that? I would like to know, because that is terribly sad.

[Hannah Bardell]

The statistic in the Stonewall Scotland report is 52%. That is specific to Scotland. I do not have the exact number, but I am very happy to get it and to share it with the hon. Gentleman. It is a significant number.

One in six LGBT people have deliberately harmed themselves in the past year. One in four LGBT people have witnessed discriminatory or negative remarks against LGBT people by healthcare staff. One in eight LGBT people have received unequal treatment in the healthcare system because of their sexual orientation or gender identity. Almost two in five trans people have avoided healthcare treatments for fear of discrimination. One in four LGBT people have experienced healthcare staff having a lack of understanding of specific lesbian, gay and bi health needs, and nearly three in five trans people have experienced healthcare staff having a lack of understanding of specific trans health needs.

I understand that some of these matters are very technical. They are challenging and they require a level of expertise. That is why education, open discussion and proper resourcing in Scotland and across the UK is absolutely vital. We know how incredibly hard staff in the NHS work in all countries and parts of the UK. We salute them. However, the studies show that there is a bit more work to be done. I want to share some of the experiences that a number of lesbian, bisexual and trans women have been kind enough to contact me and offer. Their very personal experiences and perspectives are invaluable. It is right that today in this debate we give them a voice.

One trans woman who transitioned a number of decades ago in another country, but who now lives in the UK, contacted me with her experience. She says:

“Almost all of my medical appointments have been for general medical issues. The only time I have seen anyone in the GIDS”—

Gender Identity Development Service—

“pathway was once when I had a consultation with a surgeon…regarding a long-term consequence of the particular type of gender reassignment surgery I had, which was satisfactorily resolved.”

She mentioned issues with access to drugs, but that was not necessarily about her being trans; it was about two health boards in England not speaking to each other, and it was resolved. She said that all these appointments were handled in a very courteous, respectful and professional manner. “However,” she says,

“I suspect the combination of my age, the length of time since my transition, and especially my professional status may have afforded me a certain degree of privilege. I’m not certain others, particularly younger transwomen or those who are just beginning transition, would necessarily have the same experience.”

Interestingly, she says, although all of her doctors have been aware of her transgender status, as it affects some aspects of her medical care, no doctor has ever inquired about her sexuality or whether she is sexually active.

It may be useful to know that she is a registered clinical and forensic psychologist, a long-time member of the World Professional Association For Transgender Health, an affiliate member of the British Association of Gender Identity Specialists, and a member of the editorial board of the International Journal of Transgender Health. She has been a full-time faculty member at many universities and is, by all accounts, an expert in her field.

My hon. Friend the Member for Ochil and South Perthshire (John Nicolson) just passed me a note with some of the numbers. To go back to the point made by the hon. Member for Beckenham (Bob Stewart), there are up to half a million trans people in the UK, according to the Government Equalities Office. If we break that down in terms of the percentage of Scotland’s population, a significant number of people are being affected and are considering taking their own lives, so the seriousness of that is very important. I thank my hon. Friend for that wee bit of information.

The woman who got in touch with me advises that she was recently offered a position as a psychologist at a specialist clinic in the UK. That is good news, given her expertise, but there are a number of reasons why she declined the position. In her own words:

“The most important reason why I declined the position, however, was the horrendous amount of transphobia currently rampant in the UK, spurred on by what seems to be an ever-growing number of highly inaccurate, one-sided, or genuinely bigoted and hateful articles and columns in the press…I felt that to be a trans woman working within the GIDS would place me directly on the firing line for a barrage of hatred and abuse—something which, honestly, I was not willing to endure.”

Those are the words of someone who is highly professional with specialist training, who I imagine that the NHS would have been hugely fortunate to have. That is the lived experience of a trans woman in our society, and it should give us all pause for thought and reflection.

The reality of the services not being properly or fully funded was highlighted to me by another person who contacted me. They raised the issue of the very long waiting list to access the gender identity development service. They explained that there is a

“very long (2+ years) between referral and first appointment, leaving hundreds of children and adolescents in distress for extended periods. The UK government promised an inquiry into the massive increase of referrals, but it appears to have vanished. These”

young people

“are in desperate need of better care but are being ignored. GIDS say that they should be treated under Child and adolescent mental health services (knows as CAMHS) in the interim, but for the most part CAMHS won’t touch them once gender identity issues are mentioned.”

They advised me that they

“are lucky enough to be able to afford private therapy”

but that the

“the children’s GIDS service is failing and should form part of your debate.”

I hope that the Minister will consider those matters and perhaps update not only the Chamber but me in writing, so that I can share it with the person who got in touch with me.

On gender recognition legislation and why it is needed, I was struck by a contribution by Time for Inclusive Education, which created a podcast called TIE Talks, which is well worth a listen. Mridul Wadhwa, a trans woman of colour who lives and works in Scotland, recently spoke alongside Sharon Cowan, professor of feminist and queer legal studies from Edinburgh on the podcast. They spoke compellingly about the Gender Recognition Act 2004 and the impact of the current system on the mental and physical health of trans people. I urge people to listen to it because it is hugely informative. I pay tribute to Jordan Daly and Liam Stevenson, who founded TIE, and the chair, Rhiannon Spear; they do remarkable work in Scotland for young people around LGBT education.

Mridul spoke about the patriarchal nature of the gender recognition panel and how a group of anonymous people decide other people’s future and fate in a way that echoes and has parallels, in her view, with the immigration system, which she has direct experience of. I was interested in hearing more about that and had a discussion with her about the differences and parallels of coming out as trans versus coming out as lesbian, gay or bi. She came out and transitioned in a different country, but she was clear that there are inherent similarities. I certainly remember people saying to me when I came out, “You can look forward to coming out every day.” I have to say, that is still pretty true nearly five years on, but what she told me was that as a trans person, there are so many hurdles to overcome. At times, she feels:

“how many people do I need to convince that I’m a man or a woman?”

I cannot imagine what it is like for someone to have to justify their very existence repeatedly. It must be exhausting and take a huge toll—as we saw from the statistics—on their mental and physical health. Back in 2013, a study in the US said, unsurprisingly, that legalising gay marriage might improve health and reduce healthcare costs. Another similar study last year found that legalising equal marriage could improve the mental health of same-sex couples. Wow—what a revelation! You can marry the person you love and live the life you want as the person you are, and it might actually make you happy and reduce the burden on the healthcare system.

[Colum Eastwood (Foyle) (SDLP)]

On behalf of the people of Northern Ireland, I want to thank every single Member who did the work that could not be done in Northern Ireland to ensure that our brothers and sisters were entitled to full equality where they had been denied it for far too long. One of the groups at the forefront of that campaign and of our work in particular with lesbian and bisexual women in Northern Ireland was HERe NI, but it is about to have its funding cut. Does the hon. Member agree that that cannot be allowed to happen and that the Northern Ireland Office and the Northern Ireland Executive have to do everything in their power to protect that vital service? One of the key things it does is look after the mental health of lesbian people in Northern Ireland. It cannot be allowed to happen.

[Hannah Bardell]

I agree with everything the hon. Member said. I was proud to vote for equal marriage in Northern Ireland and for abortion reform. I will not lie: it was a strange position to be in. I abstained several times to give Stormont the opportunity to get back up and running, but I was always clear that if it did not, and that if people there wanted it to happen, there would be no other option, so I was very proud to support that legislation and to see that happen. I pay tribute, as he does, to the many people who fought hard to make it happen. The thought that funding would be pulled is hugely concerning, so I agree with everything he said on that front.

We know that legislative change does not in itself necessarily change culture or fix the problem, but it is an important step. We all remember section 28— section 2A in Scotland—and how hugely damaging those discriminatory pieces of legislation were to LGBT people, not just then but now. I saw someone online recently ask how, because one of my colleagues had not even been born when that legislation came into force, it could possibly have affected her. What an outrageous and ridiculous thing to suggest. I did not have to fight for the equality I now have, but I certainly felt the effects of the discrimination that the legislation left behind, as have and do many people.

We are only now getting the inclusive education we should have had when that legislation was repealed in Scotland and across the UK. In Scotland, we are working with TIE, the Equality Network, Stonewall, the Scottish Trans Alliance and other organisations. TIE has been at the forefront of making sure that our Government in Scotland roll out inclusive education. I started school the year that that legislation came into force, and it was hugely damaging. The UK Government have also said that they are rolling out inclusive education, and I hope they stay true to that commitment, because we have to be resolved and determined to make those changes happen.

Such inclusive education is not necessarily about the details of sex of LGBT people; it is just about teaching children and young people that LGBT people exist, that some people have two mums, some people have two dads, some people have one mum, some people have one dad, some people have a mum and a dad, some people are brought up by kinship carers or grandparents. Family makeup across the UK is, and has been for many years, very varied, and we should welcome and celebrate that.

I know from my own experience that healthcare appointments can throw up unexpected issues. For many people, a smear can be a difficult and distressing thing, but for most people it will be fairly straightforward. At this point, I wish to mention the My Body Back clinic, an LGBT-inclusive clinic that provides specialist services for survivors of rape, domestic abuse and sexual violence.

A number of years ago, I went to my local service for one of my first smears after coming out. The nurse, wrongly assuming that I was heterosexual, asked what contraception I used. When I explained, “Well, for a start I am a lesbian”, her eyebrows went up and she looked a bit awkward. She said, “Oh, well, you will not need any then”, and brushed over the matter. That, unfortunately, was a wrong assumption, because lesbian and bi people do need and should be considering protection during sex.

I am going to go into some detail, which I hope will not make anyone feel too awkward. If it does, perhaps that should prompt the question of why it makes people feel awkward, and perhaps it demonstrates how important it is to discuss these issues. They are really important issues, but they are not widely discussed. Safe sex for lesbians and bi and trans people, and indeed non-binary people, is very important, particularly when it involves oral sex and the sharing of sex toys, and if you or your partner have had, or have, or suspect you have, a sexually transmitted infection or disease.

It seems that, sadly, the nurse who saw me was not apprised of those matters, but it is important for us to remember that we still live in a very hetero-normative society, and that it is not just heterosexual couples who need to ensure that they use protection against pregnancy and sexually transmitted diseases. That includes washing and the sterilisation of sex toys, but also the use of items such as dental dams. For the benefit of those who may be less well educated and not know what a dental dam is, let me explain. It acts as a barrier to prevent sexually transmitted infections from passing from one person to another. It sounds like something that would be used when people are having their teeth polished, and it was originally made for dentistry purposes and used to protect the mouth when dental work was being done, so that is not too far from the truth. However, it is now used as protection during lesbian or bi sex. Thinner versions were apparently later produced specifically for promoting safe oral sex.

I do not know whether anyone has ever tried to buy a dental dam, but they are nowhere near as readily available as condoms. In fact, they often have to be ordered via the internet. I do not want to put anyone off, but they are also not particularly nice or attractive things to use. It is interesting to note the huge innovation and investment that has been put into the development of condoms over the years—for instance, to make them thinner for maximum pleasure. They can also be ribbed, dented or flavoured. Dental dams do not come in quite the same range, for, I would imagine, a variety of reasons. The manufacturers and the marketers have not even seen fit to rename them. I think that that is an important point, and one that is little discussed.

We know how much women’s bodies are affected by contraception and the toxins that many of us put into our bodies, be they from the implant, the pill or the coil. I have been discussing that with one of my colleagues. So much of our sexual health is centred on heterosexual male pleasure, with heterosexual or bi women bearing the brunt of the responsibility for contraception.

“There is a common misconception that oral sex is ‘safe’”,

explains Simone Taylor, the education and regional lead at Brook, a sexual health charity for young people,

“But while you can’t get pregnant from oral sex, you can still catch STIs.”

In 2008, Stonewall published the results of a study of the health of 6,000 lesbian and bisexual women, which revealed that half of those who had been screened had an STI, and a quarter of those with STIs had only had sex with women in the last five years. It is very important for us to take account of those issues.

I have only a few more points to make. I know that a number of other Members want to speak. The specific health needs of disabled people who are also LGBT are often overlooked by healthcare professionals. According to Stonewall, which has produced some compelling briefings on the subject, disabled people in the LGBT community can be left with a lack of trust in their healthcare providers. Multiple needs are often not taken into account, which affects some of the most vulnerable people. LGBT people are not necessarily open about their sexual orientation and/or gender identity when seeking medical help, because of a fear of unfair treatment and invasive questioning.

Stonewall goes on to talk specifically about issues around PIP assessments and it has said that one in five non-binary people and LGBT disabled people have experienced discrimination. Similarly, one in five black, Asian and minority ethnic LGBT people, including 24% of Asian LGBT people, have experienced it. One of the testimonies it offers is from someone who was going through the PIP assessment. They said:

“I held out my hand to shake and the nurse didn’t look at myself or my wife after I introduced who she was and no eye contact throughout the interview. We felt we wanted to leave.”

Someone else who shared a testimony said:

“An NHS nurse asked about my recent gender reassignment surgery and then went on to compare me to being a paedophile as if being trans is the same thing.”

That testimony, from somebody in the east of England, was taken from Stonewall’s website and I have to say that it is hugely concerning. This reinforces the point about LGBT education and why it is so incredibly important that the misinformation that is out there and being used against trans people should be busted.

[Layla Moran (Oxford West and Abingdon) (LD)]

The hon. Lady is giving an incredibly powerful and informative speech. I have certainly learned a lot up to this point and I thank her for that. The point about intersectionality is incredibly important, and the point she makes about how important it is that sex and relationships education is delivered in schools is well made. Does she agree that it is also time to remove the exemption that allows some families to remove their children, particularly in primary schools, from age-appropriate relationship education? Headteachers who have to deliver this tell me that this is a big barrier and puts them up against their parent bodies. We need to make that stop, and help people to help themselves.

--- Later in debate ---

[Hannah Bardell]

I absolutely agree with the hon. Lady. We know that it is sometimes the most vulnerable children who are being taken out of schools who need that relationship education. That is causing huge issues. As we know, there are many LGBT young people who are suffering profoundly for various reasons, whether it is their parents taking them out of school or the schools not yet providing that education. My own sex education in high school was literally about putting a condom on a banana and a quick discussion about the pill, and that was it. It is frightful to think that that is what children were being taught, and we have come a long way, but there is still a long way to go.

The work that Time for Inclusive Education—TIE—and Pink Saltire are doing in Scotland is hugely important. In 2019, TIE delivered 41 education sessions across Scotland, and found that 85% of the pupils it worked with who had previously held negative views or had a negative attitude towards LGBT peers reported that their opinions had changed positively after TIE had delivered a session. I have seen and been involved with some of the materials that TIE has produced. Its work is not just around sexuality; it is also around harmful gender stereotypes, which have a hugely negative impact. The learning outcomes highlighted that all the young people involved had an improved understanding of challenging those stereotypes, being true to themselves and speaking up if they were struggling. The testimonies that TIE shared with me included an S1 pupil saying that they had learned

“to never bottle anything up and to speak to someone about problems”.

Another said they had learned that

“no matter how bad things are it can get better if you try”.

Another had learned that

“it’s ok to ask for help…that you shouldn’t be afraid of who you are”.

Another had learned

“that it’s ok to be a bi girl and that things will get better”.

Another had learned that

“it is fine to be LGBTQ+ and as a lesbian I felt a lot better about myself after this”.

A poster created by pupils in Primary 7 read:

“Girls can play football, we’re all equal!”

I could not agree with that more.

In closing, I just want to say how grateful I was to Members of this place, to the Speaker and to the House authorities when I recently suffered homophobic abuse—that is the only way to describe it—from a Member of the other place. I named him at the time, and I am not going to name him again, but it had a profound impact on my mental health. I also want to mention the support that I have had from the police. That was the first time I had ever experienced that kind of discrimination in my workplace. We all know that there are workplaces across the UK where LGBT people are facing discrimination, but to have experienced it in such an acute way, with a Member of the House of Lords saying homophobic things about me in the press, is still something that I find utterly incredible. There is not very much I can say about it, because the matter is ongoing, but I do want to say how grateful I am to the Members of all political parties who supported and contacted me, and to the public. The Member in question is a former MP from Northern Ireland who now sits as a life peer in the House of Lords. I received a number of emails from people in the Northern Ireland LGBT community, telling me about the damage he had done to their community over many decades. I did not know who he was before I came across him.

[Stephen Farry (North Down) (Alliance)]

I appreciate the hon. Member’s shock and revulsion at the comments that were made. May I stress that they are very much unrepresentative of Northern Ireland today? My hon. Friend the Member for Foyle (Colum Eastwood) and I are putting forward a different face of Northern Ireland for these types of debates. As the hon. Member has indicated, many people in Northern Ireland have suffered and been at the brunt of similar comments in the past, including from that Member, but I hope we are turning the page.

[Hannah Bardell]

I thank the hon. Member for his intervention, and I could not agree more. I have a deep affection for, and many friends in, Northern Ireland. I have spent a lot of time there. I got emails from people saying, “We’re so sorry. This person doesn’t represent us.” I knew that, but none the less I was heartbroken to hear of the profound impact that this individual has had on the LGBT community in Northern Ireland.

Putting that to one side, I am glad that we are having this debate. I hope all Members will agree that there is still a long way to go and that debates such as this one are part of the picture of making sure that good and proper healthcare is available for everybody in the LGBT community. We as Members must do everything we can to make sure that no one suffers from poor mental or physical health just because of their gender, sexuality or gender identity. We are all equal. At the end of the day, we are all human.

--- Later in debate ---

[Hannah Bardell]

The hon. Member has spoken extremely passionately and compellingly about the changes in Northern Ireland. Will he join me in paying tribute to the late, great Lyra McKee and the work that she did? Northern Ireland has some fine champions of equality and diversity, and she was one of the greatest. I recently had the privilege of meeting her partner, Sara Canning, who is also an incredible woman and also a great champion for LGBT equality. Lyra is sadly missed. I am sure that she will not be forgotten and that people in Northern Ireland will feel the power of her work for a very long time to come.

[Stephen Farry]

I am grateful to the hon. Member for that intervention. Indeed, Lyra McKee’s legacy has many forms, not least in terms of giving further voice to social reforms that are being delivered. Her very sad death set in a particular context efforts made by both the UK and Irish Governments over the past number of months in relation to the restoration of devolution. Her memory will live long in Northern Ireland and, indeed, far beyond our shores.

I want first to make reference to the issue of abortion that I mentioned. I stress that this is a critical issue for lesbian and bisexual women, who are more likely to be pregnant as a result of sexual crime than heterosexual women. In Northern Ireland we have a mental health crisis. Homophobic and heterosexist bias is often, sadly, deeply ingrained in our society. LBT women and trans people therefore face huge levels of discrimination and social isolation. That often relates to issues such as how relationships and sex education is taken forward in our schools. That is not being done on a purely level playing field and on a purely objective basis. Sadly, homophobic bullying is still far too often a feature for our young people having to deal with their own experiences. Last year, the Northern Ireland Council for the Curriculum, Examinations and Assessment issued an exam question stating: “Explain two negative effects of sexual orientation on the wellbeing of a young person.” That question was actually asked in an exam by a publicly funded body, so it is an example of how the situation is often loaded.

According to recent studies in Northern Ireland, about 70% of LBT women and 82% of trans people suffer from depression, and LBT women, in particular, have extremely elevated rates of self-harm. Owing to the effects of austerity and funding cuts in our health service, these issues are magnified for those facing other forms of discrimination, such as working-class LBT women, those with disabilities, and people of colour.

These are just a few examples of the policy reforms that we urgently need to see in Northern Ireland. We need proper research in terms of how we move things forward, notably on cervical screening uptake. We need rules on qualification for publicly funded IVF, and these need to be tailored for women who are in same-sex relationships. We need full implementation of donor intrauterine insemination regulations by the Regional Fertility Centre, as well as guidelines on eligibility.

We need mandatory training for healthcare professionals on aspects of healthcare such as LBT motherhood, and we need a fully operational gender identity clinic. Belfast’s clinic has the longest waiting time of anywhere in the UK, with some individuals waiting as long as five years. We must have a system that is based on self-identification, to protect trans people from being forced down the dangerous path of self-medicating.

To make matters worse, Northern Ireland’s only LBT women’s organisation, HERe, is at risk of closure due to funding ending in June. The local Health Minister has rejected several requests for meetings and instead has lumped them in with a general roundtable on LGBT issues, rather than focusing on the immediate looming consequences. That is unacceptable and needs to be addressed and reversed as a matter of urgency.

Those are some of the particular challenges facing us in Northern Ireland. There is a commonality, to an extent, in terms of the issues. But I trust Members appreciate that we are coming from a further starting point in Northern Ireland, where we have not had the same equality in law, at least in theory, while we share common concerns in terms of equality in practice. I am very grateful, on behalf of the people of Northern Ireland, to all the Members of this House who have shown leadership over the past 12 months in trying to address some of those outstanding issues in our society.

--- Later in debate ---

[Hannah Bardell]

I thank everybody who has spoken in this debate, particularly my hon. Friend, I would like to call him, the Member for Reigate (Crispin Blunt). He gave evidence to the Backbench Business Committee and has done a huge amount of work, as has Anna Robinson of the APPG on global LGBT+ rights. All speakers have conducted themselves in a respectful and thoughtful manner. This place is at its best when we agree on issues that are not often discussed and when we shine a light on issues that are sometimes discussed in a very toxic environment. I hope we have given more light than heat to those issues.

The hon. Members for Sheffield, Hallam (Olivia Blake) and for Runnymede and Weybridge (Dr Spencer) are new Members who have come to this place with experience and insight as health professionals, and I think that will serve us all well. I listened with interest to their contributions on the work that they are doing and have done, which is hugely important.

The hon. Member for North Down (Stephen Farry) brought the Northern Irish perspective. As he rightly said, there have been huge leaps forward in recent times. We wish him and the people of Northern Ireland well as they embark on, hopefully, a new chapter in their history, but also in terms of equality for LGBT people. My hon. Friend the Member for Linlithgow and East Falkirk (Martyn Day) brought the specific Scottish perspective and was able to put a number of points that I did not have time to make—I felt I had been indulgent enough.

The hon. Member for Ellesmere Port and Neston (Justin Madders) highlighted some of the major health challenges that LBT women face, and talked specifically about the report that the Women and Equalities Committee produced on health and social care for the LGBT community. That was a really insightful report and drew on such a wide range of experience. That is why the Committees of this House are so important, and why making sure they function properly is incredibly important. The Minister gave a very thoughtful response, and I know that our constituents and, I hope, the LGBT community will take a lot from that. We know there is still a long way to go, and I hope that she will be able to address the specific points that I raised on behalf of the people who got in touch with me, perhaps in a letter. It was very powerful reading their testimonies and reading the concerns that they had. They show that there is still a long way to go, particularly for those in the trans community seeking to get services.

We have a particular challenge in Scotland. One of the testimonies that the Pink Saltire included in a film that it made a couple of years ago, which I rewatched in preparation for this debate, was from a non-binary person who had to have surgery in England and had to fly home, leading to stitches bursting and terrible scarring. That is real detail that is not much talked about, but we have to reflect on it and make sure that in all parts of the UK and all countries in the UK there are the right services, and people can be treated and supported as close to home as possible.

We have to thank the Backbench Business Committee once again, and you, Mr Deputy Speaker. It has been an important debate and I know that the LGBT community will be grateful to Members for raising these issues. I hope it will take us a step forward in our fight for equality.

Question put and agreed to.

Resolved,

That this House has considered lesbian, bisexual and trans women’s health inequalities.